Individual provider Active NPI

James S Havran, C.O., L.O.

  • Prosthetic/Orthotic Supplier
  • San Antonio, TX
National Provider Identifier
1609860048
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
445 Issued in TX
Practice address
2122 Babcock Rd Ste 102
San Antonio, TX 78229-4411
Phone
(210) 692-1111
Fax
(210) 692-6041
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 445 TX
Prosthetic/Orthotic Supplier 335E00000X 445 TX Primary

Addresses

Primary practice location

2122 Babcock Rd Ste 102
San Antonio, TX 78229-4411

Mailing address

2122 Babcock Rd Ste 102
San Antonio, TX 78229-4411
Phone (210) 692-1111

Other identifiers 5

IdentifierTypeStateIssuer
176253503MedicaidTX
176263501MedicaidTX
176263505MedicaidTX
176263504MedicaidTX
176263502MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
445TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Orthotics Plus LLC Durable Medical Equipment & Medical Supplies Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1609860048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 BABCOCK RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294411",
            "telephone_number": "210-692-1111",
            "fax_number": "210-692-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 BABCOCK RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294411",
            "telephone_number": "210-692-1111",
            "fax_number": "210-692-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVRAN",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "C.O., L.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "445",
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176253503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176263501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176263505",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176263504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176263502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.